<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
        
        <div class="layui-form-item">
            <label class="layui-form-label">姓名</label>
            <div class="layui-input-block">
                <input type="text" name="name" class="layui-input" lay-verify="required" placeholder="请输入姓名" value="{$row.name|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系电话</label>
            <div class="layui-input-block">
                <input type="text" name="phone" class="layui-input" lay-verify="required" placeholder="请输入联系电话" value="{$row.phone|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label ">图片</label>
            <div class="layui-input-block layuimini-upload">
                <input name="images" class="layui-input layui-col-xs6" placeholder="请上传图片 以 | 做分割符号"
                       value="{$row.images|default=''}">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn" data-upload="images" data-upload-number="more"
                             data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image" data-upload-sign=""><i
                            class="fa fa-upload"></i> 上传</a></span>
                    <span><a class="layui-btn layui-btn-normal" id="select_images" data-upload-select="images"
                             data-upload-number="more" data-upload-mimetype="image/*" data-upload-sign=""><i
                            class="fa fa-list"></i> 选择</a></span>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">意见反馈内容</label>
            <div class="layui-input-block">
                <textarea name="content" id="content" class="layui-textarea">{$row.content|default=''}</textarea>
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>
    </form>
</div>